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      Kissing Bugs in the United States: Risk for Vector-Borne Disease in Humans

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          Abstract

          Eleven species of kissing bugs are found in the United States. Their home ranges may be expanding northward, perhaps as a consequence of climate change. At least eight of the species, perhaps all, are reported to harbor Trypanosoma cruzi, the parasite that causes Chagas disease. Because humans are encroaching on kissing bug habitat, there is concern for vector-transmitted Chagas disease in the United States. To date, documented autochthonous cases of Chagas in humans in the United States are rare. Kissing bugs are capable of adapting to new habitats such as human domiciles; however, they do not colonize homes in the United States as in Central and South America. We review the biology, behavior, and medical importance of kissing bugs and the risk they pose for transmission of Chagas disease in the United States. Where possible, descriptions of US species are compared to the epidemiologically important Latin American species.

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          Most cited references102

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          Transmission and epidemiology of zoonotic protozoal diseases of companion animals.

          Over 77 million dogs and 93 million cats share our households in the United States. Multiple studies have demonstrated the importance of pets in their owners' physical and mental health. Given the large number of companion animals in the United States and the proximity and bond of these animals with their owners, understanding and preventing the diseases that these companions bring with them are of paramount importance. Zoonotic protozoal parasites, including toxoplasmosis, Chagas' disease, babesiosis, giardiasis, and leishmaniasis, can cause insidious infections, with asymptomatic animals being capable of transmitting disease. Giardia and Toxoplasma gondii, endemic to the United States, have high prevalences in companion animals. Leishmania and Trypanosoma cruzi are found regionally within the United States. These diseases have lower prevalences but are significant sources of human disease globally and are expanding their companion animal distribution. Thankfully, healthy individuals in the United States are protected by intact immune systems and bolstered by good nutrition, sanitation, and hygiene. Immunocompromised individuals, including the growing number of obese and/or diabetic people, are at a much higher risk of developing zoonoses. Awareness of these often neglected diseases in all health communities is important for protecting pets and owners. To provide this awareness, this review is focused on zoonotic protozoal mechanisms of virulence, epidemiology, and the transmission of pathogens of consequence to pet owners in the United States.
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            Trypanosoma cruzi and Chagas' Disease in the United States.

            Chagas' disease is caused by the protozoan parasite Trypanosoma cruzi and causes potentially life-threatening disease of the heart and gastrointestinal tract. The southern half of the United States contains enzootic cycles of T. cruzi, involving 11 recognized triatomine vector species. The greatest vector diversity and density occur in the western United States, where woodrats are the most common reservoir; other rodents, raccoons, skunks, and coyotes are also infected with T. cruzi. In the eastern United States, the prevalence of T. cruzi is highest in raccoons, opossums, armadillos, and skunks. A total of 7 autochthonous vector-borne human infections have been reported in Texas, California, Tennessee, and Louisiana; many others are thought to go unrecognized. Nevertheless, most T. cruzi-infected individuals in the United States are immigrants from areas of endemicity in Latin America. Seven transfusion-associated and 6 organ donor-derived T. cruzi infections have been documented in the United States and Canada. As improved control of vector- and blood-borne T. cruzi transmission decreases the burden in countries where the disease is historically endemic and imported Chagas' disease is increasingly recognized outside Latin America, the United States can play an important role in addressing the altered epidemiology of Chagas' disease in the 21st century.
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              Classification, evolution, and species groups within the Triatominae.

              Classification of the Triatominae has become a complex balance between traditional approaches and a wide variety of evolutionary interpretations. On the one hand is the need for a stable classification of practical use for those involved in vector surveillance and control. On the other is the desire to adequately reflect evolutionary theory derived from a range of molecular, cytogenetic and morphometric comparisons, with additional complications raised by current interpretations of the subfamily as a recently derived polyphyletic assemblage. Here we review key aspects of triatomine systematics and evolution, to derive a pragmatic classification that seeks to build on traditional morphological concepts within the context of current evolutionary theories.
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                Author and article information

                Journal
                Environ Health Insights
                Environ Health Insights
                Environmental Health Insights
                Environmental Health Insights
                Libertas Academica
                1178-6302
                2014
                10 December 2014
                : 8
                : Suppl 2
                : 49-59
                Affiliations
                [1 ]Division of Infectious Diseases, University of Arizona, Tucson, USA.
                [2 ]Department of Biological Sciences, Loyola University New Orleans, New Orleans, USA.
                [3 ]School of Veterinary Medicine, MPVM Program, University of California, Davis, USA.
                [4 ]Southwestern Biological Institute, Tucson, USA.
                Author notes
                Article
                ehi-suppl.2-2014-049
                10.4137/EHI.S16003
                4264683
                25574143
                d363f539-dc47-4d3b-a963-70f93c7fc2ed
                © 2014 the author(s), publisher and licensee Libertas Academica Ltd.

                This is an open-access article distributed under the terms of the Creative Commons CC-BY-NC 3.0 License.

                History
                : 04 August 2014
                : 16 September 2014
                : 22 September 2014
                Categories
                Review

                Public health
                kissing bugs,triatomine,trypanosoma cruzi,chagas disease,anaphylaxis,kissing bug bites,pest management

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